Impact of specific patterns on the sensitivity for follicular and Hurthle cell carcinoma in thyroid fine-needle aspiration

Hurthle cell of adenoma of thyroid gland is rare neoplasms of the thyroid. Size more than 4 cm is rare finding and moreover the occurrence of a multifocal Hurthle cell adenoma is not supported by antecedents in literature. Sonography fails to identify its potentials for malignancy while fine needle aspiration cytology couldn’t differentiate it from Hurthle cell carcinoma of thyroid. The management of Hurthle cell adenoma and Hurthle cell carcinoma is quite different and hence diagnostic dilemma should be sorted out early. A 26 year old female presented with bilateral thyroid swelling. Ultrasonography of thyroid gland showed complex solid cystic nodules in bilateral thyroid lobes with right thyroid lobe measuring 4.1×3.4×2.5 cm and left thyroid lobe measure 3.1×1.7×1.6 cm. Fine needle aspiration cytology (FNAC) was suggestive of papillary malignancy with extensive Hurthle cell changes (Class V, Bethesda classification). The patient underwent total thyroidectomy with bilateral parathyroid gland preservation. Histopathology revealed it as Hurthle cell adenoma (HCA) involving bilateral lobe and multifocal in nature. The treatment of choice for Hurthle cell carcinoma is total thyroidectomy with neck dissection depending on the nature of the lesions. However the treatment of Hurthle cell adenoma is only hemithyroidectomy or lobectomy as it is a benign condition. Differentiation of these two entirely different conditions warrants more studies.

Download Full-text

Comparison of Folicular, Hurthle Cell Neoplasm and Oncocytic Changes Diagnosed by Thyroid Fine Needle Aspiration with Postoperative Histopathological Results

Turkish Journal of Endocrinology and Metabolism ◽

10.4274/tjem.2408 ◽

2014 ◽

Vol 18/ (1) ◽

pp. 5-12

Author(s):

Yusuf Aydın ◽

Mehmet Turgut ◽

Melih Engin Erkanlı ◽

İsmet Özaydın ◽

Murat Oktay ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Needle Aspiration ◽

Fine Needle ◽

Hürthle Cell ◽

Cell Neoplasm ◽

Thyroid Fine Needle Aspiration ◽

Histopathological Results

Download Full-text

Appearance of Hürthle cell carcinoma soon after surgical extirpation of Hürthle cell adenoma and follicular adenoma of the thyroid gland

Radiology and Oncology ◽

10.2478/raon-2014-0047 ◽

2015 ◽

Vol 49 (1) ◽

pp. 26-31 ◽

Cited By ~ 4

Author(s):

Nevena Ristevska ◽

Sinisa Stojanoski ◽

Daniela Pop Gjorceva

Keyword(s):

Thyroid Gland ◽

Cell Carcinoma ◽

Tumour Size ◽

Follicular Adenoma ◽

Needle Aspiration ◽

Cell Adenoma ◽

Rare Tumour ◽

Hürthle Cell ◽

Hürthle Cell Carcinoma ◽

Hurthle Cell Carcinoma

Abstract Background. Hürthle cell neoplasms could be benign (Hürthle cell adenoma) or malignant (Hürthle cell carcinoma). Hürthle cell carcinoma is a rare tumour, representing 5% of all differentiated thyroid carcinomas. The cytological evaluation of Hürthle cell neoplasms by fine needle aspiration biopsy (FNAB) is complicated because of the presence of Hürthle cells in both Hürthle cell adenoma and Hürthle cell carcinoma. Thus, the preoperative distinction between these two entities is very difficult and possible only with pathohistological findings of the removed tumour. Case report. A 57-year old female patient was admitted at our Department, for investigation of nodular thyroid gland. She was euthyroid and FNAB of the nodules in both thyroid lobes were consistent of Hürthle cell adenoma with cellular atypias. After thyroidectomy the histopathology revealed Hürthle cell adenoma with high cellular content and discrete cellular atypias in the left lobe and follicular thyroid adenoma without cellular atypias in the right lobe. One year after substitution therapy, a palpable tumour on the left side of the remnant tissue was found, significantly growing with time, presented as hot nodule on 99mTc-sestamibi scan and conclusive with Hürthle cell adenoma with marked cellularity on FNAB. Tumorectomy was performed and well-differentiated Hürthle cell carcinoma detected. The patient received ablative dose of 100 mCi 131I. No signs of metastatic disease are present up to date. Conclusions. The differences between Hürthle cell adenomas and Hürthle cell carcinomas could be clearly made only by histopathological evaluation. Patients with cytological diagnosis of Hürthle cell neoplasms should proceed to total thyroidectomy, especially if tumour size is > 1cm, FNAB findings comprise cellular atypias and/or multiple bilateral nodules are detected in the thyroid gland.

Download Full-text

Overview of Hurthle cell carcinoma of thyroid

Advances in Modern Oncology Research ◽

10.18282/amor.v3.i4.130 ◽

2017 ◽

Vol 3 (4) ◽

Author(s):

Martin A Korzeniowski ◽

Aamer Mahmud ◽

Angus Kirby ◽

Kurian Joseph ◽

Evgeny Sadikov ◽

...

Keyword(s):

Cell Carcinoma ◽

Frozen Section ◽

Treatment Decision ◽

Needle Aspiration ◽

Ethanol Ablation ◽

Hürthle Cell ◽

Systemic Treatments ◽

Hürthle Cell Carcinoma ◽

Hurthle Cell Carcinoma ◽

Radioactive Iodine Ablation

The clinical behaviour of Hurthle cell carcinoma (HCC) of the thyroid is variable and there are many controversies in the literature. Here, we summarize an up-to-date review of the literature on genetics, diagnosis (ultrasound scan, fine needle aspiration, frozen section, etc.), and management. At presentation, treatment decision should be made by a multidisciplinary board. Recurrent HCCs are seldom curable despite salvage treatments, which include radioactive iodine ablation, radiofrequency ablation, ethanol ablation, external radiotherapy, and systemic therapy. Further research is needed to develop more efficacious systemic treatments. Currently, lenvatinib, sunitinib, and sorafenib are available. The completed and ongoing clinical trials for HCC are summarized.

Download Full-text